Complications and Efficiency of Liver Biopsies using the Tru-Cut Biopsy Gun

Abstract

Objectives: The study aimed to evaluate the complications and quality of the specimens of percutaneous liver biopsy in patients with chronic viral hepatitis who were scheduled for treatment and also to evaluate the contribution of the knowledge of ultrasound guided (USG) biopsy localization to the existing data. Methodology: Liver biopsies conducted at our clinic between 2003 and 2008 were retrospectively evaluated. In 53.8% of the cases, hepatobiliary USG was performed to mark the localization of the biopsy site. An automatically triggered Tru-Cut biopsy gun was used. Results: Biopsies waere taken from the livers of 236 patients (46.6% male, 53.4% female) with a mean age of 47.1 ± 12.5 years. The majority of patients had hepatitis C (61.9%); 1.6% experienced major complications (3 patient biliary peritonitis, 1 patient liver bleeding); 52.1% of the samples were ≥ 1 cm in length; And 69.7% of the biopsy samples with specified portal area had ≥ 4 portal areas. There was no statistically significant difference between the patients with localized and non-localized biopsy site in terms of major complications and length of biopsy samples ( respectively p = 1.000, p = 0.209 ). Conclusion: We believe that percutaneous liver biopsy using Tru-Cut biopsy gun can be peformed safely, with complications in 1.6% of the procedures. The length of the biopsy specimen is shorter than ideal values. Evaluation of the patients with and without USG-guided biopsy revealed no significant difference in terms of major complications and specimen size.

Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series

“…Nevertheless, it has major disadvantages; it is an invasive method with a risk of complication and there are difficulties in evaluating the biopsy specimen. Biopsy of the liver under US guidance increases the diagnostic yield by obtaining sufficient liver specimen, subsequently increasing the probability of definitive pathological diagnosis (1, 2, 4, 5, 10, 13). In our series, the overall rates of complications were only 3% and most of them (80.6%) were minor and self-limited.…”

“…In many liver diseases, liver biopsy is still a gold standard for diagnosis, prognostication and assistance in determining the treatment plan. The increasing popularity of these procedures stems in part from their less invasive nature, lower risk compared with surgery, high diagnostic accuracy and substantial cost-effectiveness (1-10). …”

Selective transitional zone sampling approach versus random biopsy in cases with malignant liver masses: Is there any superiority?

“…After obtaining biopsy from these two locations, patients were kept under observation by the radiologist in the operating room for 4 hours for possible complications. We classified all complications into two groups as major and minor (11). Major complications were described as hemorrhage, bile leakage, biliary peritonitis, hemobilia, pneumothorax, sep- tic shock, and death.…”

“…Apoptosis and necrosis can occur in the central part of these masses, especially in large primary or metastatic lesions (Figure 1a and b). This necrotic tissue can be problematic for the pathologic diagnosis, necessitating repetition of biopsy, but it should not be forgotten that liver biopsies have a 0.32% risk for mortality and 35% for morbidity (11,12). Therefore, it must be aimed to obtain diagnostic sensitivity for the pathologic diagnosis in one attempt and to preclude repetition of the biopsy.…”

Evaluation of Safety and Efficacy of Liver Biopsy Following Liver Transplant

“…The increased popularity of liver biopsy is because it is less invasive and has lower risk than surgery, has high diagnostic accuracy, and is cost effective. 1,2 Although liver biopsy is an easy procedure for hospitalized patients and outpatients, some complications or technical failures may occur in 5% patients, including pain that causes hospital admission, bleeding that necessitates transfusion or surgery, pneumothorax, failure to obtain tissue, and obtaining other tissues. [3][4][5] However, attempts should be made to increase safety and decrease complications of liver biopsy.…”